2022年06月六级第1套长篇阅读匹配原文翻译及答案

A) Fazila is a young woman that has been dealing with eczema (湿疹), a common skin condition, for the past five years, but never got it treated. The nearest hospital is an hour away, by boat and bus, and her skin condition didn't seem serious enough to make the trek, so she ignored it- until a new technology brought the doctor to her. Fazila lives on one of the remote river islands in northern Bangladesh. These islands are low-lying, temporary sand islands that are continuously formed and destroyed through sand buildup and erosion. They are home to over six million people, who face repeated displacement from flooding and erosion- which may be getting worse because of climate change-and a range of health risks, including poor nutrition, malaria (疟疾) and other water-borne diseases.

法齐拉是一位年轻女性，过去五年一直患有湿疹（一种常见的皮肤病），但从未得到治疗。最近的医院需要乘船和公交车一小时才能到达，而且她的皮肤状况似乎不严重到值得长途跋涉，所以她忽略了它——直到一项新技术将医生带到了她身边。法齐拉居住在孟加拉国北部的一个偏远河岛上。这些岛屿是低洼的临时沙岛，通过沙堆积和侵蚀不断形成和消失。它们是超过六百万人的家园，这些人面临反复因洪水和侵蚀而流离失所的风险——由于气候变化，这种情况可能正在恶化——以及一系列健康风险，包括营养不良、疟疾和其他水传播疾病。

B) The most dangerous thing for these remote island dwellers is land erosion. The second is lack of access to medical supplies and doctors. There are no doctors within miles, and while child mortality and maternal death have gone down in the rest of the country, this is not the case for the islands. The medical situation is so bad that it really takes away from the quality of their life. Yet for many island inhabitants—some of Bangladesh's poorest- paying for health care is a costly ordeal. Victims of erosion lose their houses, agricultural land and jobs as farmers, fishermen and day laborers. Though government hospitals are free, many people hesitate to go, citing long commutes, endless lines and questionable diagnoses. For convenience's sake, one-third of rural households visit unqualified village doctors, who rely on unscientific methods of treatment, according to a 2016 study in the peer-reviewed journal Global Health Action.

对于这些偏远岛屿居民来说，最危险的事情是土地侵蚀。其次是缺乏医疗用品和医生。方圆数英里内没有医生，虽然该国其他地区的儿童死亡率和产妇死亡率已下降，但岛屿情况并非如此。医疗状况如此糟糕，确实降低了他们的生活质量。然而，对于许多岛民——孟加拉国最贫困的一些人——支付医疗费用是一场昂贵的磨难。侵蚀的受害者失去房屋、农田以及作为农民、渔民和日工的工作。尽管政府医院是免费的，但许多人犹豫不前，理由是路途遥远、无尽的排队和可疑的诊断。为了方便，三分之一的农村家庭就诊于不合格的村医，他们依赖不科学的治疗方法，根据同行评审期刊《全球卫生行动》2016年的一项研究。

C) On the islands, there's even a colloquial (口头的) expression for the idea of making medical care your lowest priority: It's known as "rog pushai rakhâ" in Bengali, which roughly translates to "stockpiling their diseases" - waiting to seek medical attention until a condition becomes extremely serious. Now, a new virtual medical service called Teledaktar (TD) is trying to make health care more easily accessible. Every week, TD's medical operators travel to the islands by boat, carrying a laptop, a portable printer for prescriptions and tools to run basic medical screenings such as blood pressure, blood sugar, body temperature and weight. They choose an area of the island with the best Internet reception and set up a makeshift (临时凑合的) medical center which consists of plastic stools and small tables borrowed from the locals' homes, a tent in case of rain and a sheet that is strung up to give the patients privacy during their session.

在岛上，甚至有一个口语表达来形容将医疗保健置于最低优先级的想法：在孟加拉语中被称为"rog pushai rakhâ"，大致翻译为"囤积他们的疾病"——等到病情变得极其严重才寻求医疗救治。现在，一项名为Teledaktar（TD）的新虚拟医疗服务正试图让医疗保健更易获得。每周，TD的医疗操作员乘船前往岛屿，携带笔记本电脑、用于处方的便携式打印机以及运行基本医疗筛查的工具，如血压、血糖、体温和体重。他们选择岛上互联网接收最好的区域，搭建一个临时凑合的医疗中心，由从当地人家借来的塑料凳和小桌子、防雨帐篷以及挂起以在治疗过程中保护患者隐私的床单组成。

D) Launched in October 2018, TD has eight centers in towns and villages across rural Bangladesh and on three islands. It is funded by a nonprofit organization founded by Bangladeshi entrepreneurs, finance and technology professionals. Inside the center, the laptop screen lights up to reveal Dr. Tina Mustahid, TD's head physician, live-streamed (网络直播) from the capital city of Dhaka for free remote medical consultations. Affectionately called Doctor Apa — "older sister" in Bengali- by her patients, she is one of three volunteer doctors at TD.

TD于2018年10月推出，在孟加拉国农村地区的城镇和村庄以及三个岛屿上设有八个中心。它由一个由孟加拉国企业家、金融和技术专业人士创立的非营利组织资助。在中心内部，笔记本电脑屏幕亮起，显示TD的首席医生蒂娜·穆斯塔希德博士从首都达卡进行免费远程医疗咨询的网络直播。患者亲切地称她为Doctor Apa——在孟加拉语中意为"姐姐"——她是TD的三名志愿医生之一。

E) "I diagnose them through conversation, says Dr. Mustahid. "Sometimes it's really obvious things that local doctors don't have the patience to talk through with their patients. For example, a common complaint mothers come in with is that their children refuse to eat their meals. The mothers are concerned they are dealing with indigestion, but it's because they are feeding the children packaged chips which are cheap and convenient. I tell them it is ruining their appetite and ask them to cut back on unhealthy snacks." Dr. Mustahid says building awareness about health and nutrition is important for island patients who are cut off from mainland resources.

"我通过对话诊断他们，"穆斯塔希德博士说。"有时是显而易见的事情，当地医生没有耐心与患者详细讨论。例如，母亲们常抱怨的一个问题是孩子拒绝吃饭。母亲们担心孩子患有消化不良，但实际上是因为她们给孩子喂食便宜方便的包装薯片。我告诉她们这会破坏孩子的食欲，并要求她们减少不健康的零食。"穆斯塔希德博士表示，对于与大陆资源隔绝的岛屿患者来说，建立健康和营养意识非常重要。

F) Even off the islands, Bangladesh faces a critical deficit of health services. The country has half the doctors-per-person ratio recommended by the World Health Organization: roughly one doctor per 2,000 people, instead of one doctor per 1,000 people. And of those physicians, many are concentrated in cities: 70% of the country's population live in rural areas, yet less than 20% of health workers practice there. Over 70% of TD's 3,000 patients are female, in part because many are not comfortable speaking with local doctors who tend to be male. The rural women are mostly not literate or confident enough to travel on their own to the nearest town to visit medical facilities. Many have spent their entire lives rebuilding their homes when the islands flood. Early marriage and young motherhood, which are prevalent in these parts of Bangladesh, also contribute to the early onset of health problems.

即使离开岛屿，孟加拉国也面临严重的医疗服务短缺。该国的医生人均比例只有世界卫生组织推荐标准的一半：大约每2000人一名医生，而不是每1000人一名医生。而在这些医生中，许多集中在城市：全国70%的人口居住在农村地区，但不到20%的医疗工作者在那里执业。TD的3000名患者中超过70%是女性，部分原因是许多人不习惯与当地通常是男性的医生交谈。农村女性大多没有受过教育或不够自信，无法自行前往最近的城镇访问医疗设施。许多人一生都在岛屿洪水时重建家园。早婚和年轻母亲在孟加拉国这些地区普遍存在，也导致健康问题早期发作。

G) For most TD patients on the islands, Dr. Mustahid is the first big-city doctor that they've ever consulted. TD doctors are not meant to treat serious illnesses or conditions that require a doctor to be physically present, such as pregnancy. But they can write prescriptions, diagnose common ailments— including digestive issues, joint pain, skin diseases, fever and the common cold—and refer patients to doctors at local hospitals. The visit is also an opportunity for the patients, especially women, to air their concerns about aging, motherhood and reproductive health according to Dr. Mustahid. The doctors also offer health, dietary and lifestyle advice where necessary, including insight on everything from recognizing postnatal (产后的) depression to daily exercise. Dr. Mustahid regularly recommends her patients to take a daily thirty-minute morning walk before the sun gets too intense.

对于岛上大多数TD患者来说，穆斯塔希德博士是他们咨询过的第一位大城市医生。TD医生不旨在治疗严重疾病或需要医生亲自到场的状况，如怀孕。但他们可以开处方、诊断常见疾病——包括消化问题、关节痛、皮肤病、发烧和普通感冒——并转诊患者到当地医院的医生。据穆斯塔希德博士称，就诊也是患者，尤其是女性，表达对衰老、母亲身份和生殖健康担忧的机会。医生们还在必要时提供健康、饮食和生活方式建议，包括从识别产后抑郁到日常锻炼的各方面见解。穆斯塔希德博士定期建议患者在太阳变得太强烈之前进行每天三十分钟的晨间散步。

H) After a few sessions about general health issues Fazila finally opened up about something else that was bothering her: her persistent skin condition. It can get expensive to travel to the doctor, so usually the women living on the islands describe their illness to their husbands. The husbands then go to the pharmacy, try to describe the issue and return home with some random medicines. Nothing worked for Fazila until she started seeing Dr. Apa.

在几次关于一般健康问题的咨询后，法齐拉终于敞开心扉谈到了困扰她的另一件事：她持续的皮肤状况。去看医生可能很昂贵，因此通常居住在岛上的女性会向丈夫描述自己的病情。然后丈夫去药房，试图描述问题并带回家一些随机的药物。对法齐拉来说，什么都没有效果，直到她开始见Apa医生。

I) Other nonprofits are also starting to provide health services on the islands. A local non-governmental organization called Friendship operates floating boat hospitals that provide health services to islands all over Bangladesh, docking at each for two months at a time. Friendship also runs satellite clinics in which one doctor and one clinic aide who are residents of the community disperse health and hygiene information.

其他非营利组织也开始在岛上提供卫生服务。一个名为"友谊"的当地非政府组织运营浮动船医院，为孟加拉国各地的岛屿提供卫生服务，每次在每个岛屿停靠两个月。"友谊"还运营卫星诊所，其中一名医生和一名来自社区的诊所助手传播健康和卫生信息。

J) TD still has a few major challenges. Many residents complain the medicines they are prescribed are sometimes unaffordable, but the government isn't doing enough for them. Patients often ask why the medicine isn't free along with the consultation from the doctors. The organizations are linked to local pharmacies and offer discounts to the patients and make sure to prescribe the most cost-effective brands, but still many residents can't afford even that.

TD仍然面临一些重大挑战。许多居民抱怨他们处方的药物有时负担不起，但政府没有为他们做足够多。患者常常问为什么药物不能与医生的咨询一起免费。这些组织与当地药房联系，为患者提供折扣，并确保开最经济实惠的品牌，但即使如此，许多居民仍然负担不起。

K) Nevertheless, TD's remote consultations seem to be popular: Of 3,000 patients, at least 200 have returned for follow-ups, according to TD. The reason, explains one resident, might be the simple gesture of treating the island inhabitants with respect. Dr. Apa is patient," he says, "At government hospitals, the doctors treat us very badly, but here they listen to us, I can repeat myself many times and no one gets annoyed."

尽管如此，TD的远程咨询似乎很受欢迎：根据TD的数据，在3000名患者中，至少有200人已返回进行随访。一位居民解释说，原因可能是尊重岛民这一简单的举动。"Apa医生很有耐心，"他说，"在政府医院，医生对待我们很差，但在这里他们倾听我们，我可以重复多次，没有人会生气。"